Journal of critical care最新文献

{"title":"Peripherally administered vasopressin initiated in the emergency department","authors":"Kyle McCurry ,&nbsp;Kyle DeWitt ,&nbsp;Cameron P. Upchurch ,&nbsp;Rebecca Nashett Wren","doi":"10.1016/j.jcrc.2025.155363","DOIUrl":"10.1016/j.jcrc.2025.155363","url":null,"abstract":"<div><h3>Context</h3><div>Vasopressors are frequently administered in the emergency department (ED) to improve hemodynamic stability in critically ill patients. Due to their potent vasoconstrictive properties, these medications are typically delivered through a central venous catheter (CVC) to minimize the risk of extravasation or infiltration. The use of peripheral venous access for administering vasopressors has grown as more safety data has been published; however, the majority of data does not include vasopressin.</div></div><div><h3>Objective</h3><div>The purpose of this study was to evaluate the incidence of reported infiltrations or extravasations following the administration of peripheral vasopressin.</div></div><div><h3>Design</h3><div>A single-center, retrospective study between 2014 and 2024.</div></div><div><h3>Setting</h3><div>Seventy-nine-bed ED in a 620-bed academic tertiary medical center.</div></div><div><h3>Patients</h3><div>A total of 80 patients received vasopressin via peripheral administration in the ED.</div></div><div><h3>Results</h3><div>The median duration of peripheral vasopressin administration was 444 min [IQR 196, 1314]. The documented minimum and maximum rates of vasopressin were 0.01 units/min and 0.08 units/min, respectively, with a median rate of 0.03 units/min [IQR 0.03, 0.04]. There were no reports or incidents of infiltration or extravasation related to the administration of peripheral vasopressin. Although patients initially received peripheral vasopressin, 26 patients (32.5 %) were later transitioned to CVC administration.</div></div><div><h3>Conclusions</h3><div>With no observed instances of infiltration, extravasation, or other related complications, peripheral administration of vasopressin initiated in the ED for select, hemodynamically compromised patients may represent a feasible approach to initiate early vasopressor therapy while allowing clinicians to more carefully weigh the risks and benefits of CVC placement. Future research should focus on prospective, multicenter studies to validate these findings in larger and more diverse patient populations.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155363"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor:“ The clinical outcome of Montelukast versus co-enzyme Q10 in adult patients with sepsis: A randomized controlled clinical trial”","authors":"Ying Han","doi":"10.1016/j.jcrc.2025.155317","DOIUrl":"10.1016/j.jcrc.2025.155317","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155317"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous diuresis as a marker of successful liberation from positive pressure ventilation: A retrospective observational study","authors":"Yael Lichter ,&nbsp;Amir Gal Oz ,&nbsp;Itay Moshkovits ,&nbsp;Ron Wald ,&nbsp;Dekel Stavi ,&nbsp;Noam Goder","doi":"10.1016/j.jcrc.2025.155355","DOIUrl":"10.1016/j.jcrc.2025.155355","url":null,"abstract":"<div><h3>Background</h3><div>Positive pressure ventilation (PPV) alters hemodynamics and neurohormonal regulation, leading to sodium and water retention. Transition to unassisted breathing is expected to reverse these effects, but the magnitude and clinical relevance of this have not been fully characterized.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study of adult ICU patients, who underwent planned PPV discontinuation (PPVdc). Patients receiving dialysis or intravenous furosemide within ±24 h of PPVdc were excluded. Changes in urine output (UO) and mean arterial pressure (MAP) were analyzed for the entire cohort and compared between successful versus failed PPVdc.</div></div><div><h3>Results</h3><div>687 patients met the eligibility criteria, of whom 587 (85 %) had successful PPVdc. Mean hourly UO increased significantly in the 6 h following PPVdc (118.2 ± 76.8 mL/h vs 85.7 ± 48.1 prior to PPVdc, <em>p</em> &lt; 0.01) and during the 24 h following PPVdc (108.9 ± 54.7 mL/h vs 87.5 ± 43.0 prior to PPVdc, p &lt; 0.01). MAP rose concurrently by 8–10 % over the same periods (p &lt; 0.01). UO increases were significantly greater in successful compared with failed PPVdc at 6 h (adjusted difference = +18.8 mL/h; 95 % CI +4.5 to +33.1; <em>p</em> = 0.01)., findings further confirmed by propensity score–matched analysis.</div></div><div><h3>Conclusions</h3><div>PPVdc was associated with prompt and sustained increase in UO and a concomitant rise in MAP. Greater diuresis was linked to successful liberation from PPV, suggesting that mobilization of retained fluid is a marker of recovery, and the lack of it may help identify patients at higher risk of PPVdc failure. Prospective studies should explore whether proactive fluid management around the time of PPVdc could improve weaning outcomes.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155355"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What every intensivist should know about…methylene blue in septic shock","authors":"Shannon M. Fernando ,&nbsp;Karim Soliman ,&nbsp;Alexandre Tran ,&nbsp;Salmaan Kanji ,&nbsp;Bram Rochwerg","doi":"10.1016/j.jcrc.2025.155353","DOIUrl":"10.1016/j.jcrc.2025.155353","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155353"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Derivation and validation of a prediction rule for sedative-associated delirium during acute respiratory failure requiring mechanical ventilation","authors":"Niall T. Prendergast ,&nbsp;Chukwudi A. Onyemekwu ,&nbsp;Kelly M. Toth ,&nbsp;Christopher A. Franz ,&nbsp;Georgios D. Kitsios ,&nbsp;Bryan J. McVerry ,&nbsp;Pratik P. Pandharipande ,&nbsp;E. Wesley Ely ,&nbsp;Timothy D. Girard","doi":"10.1016/j.jcrc.2025.155407","DOIUrl":"10.1016/j.jcrc.2025.155407","url":null,"abstract":"<div><h3>Objective</h3><div>To derive and validate a simple, transparent model that quantifies risk for sedative-associated delirium in mechanically ventilated ICU patients, which could be used to guide decisions about personalized sedation.</div></div><div><h3>Design</h3><div>We performed backward stepwise logistic regression to derive a model predictive of sedative-associated delirium. We validated this model internally using hundredfold bootstrapping. We then validated this model externally in a separate prospective cohort of mechanically ventilated ICU patients.</div></div><div><h3>Setting</h3><div>Five US hospitals, including one academic, one private, and three veterans hospitals.</div></div><div><h3>Patients</h3><div>The parent cohort consisted of 1040 patients with either septic or cardiogenic shock, acute respiratory failure, or both. From the parent cohort 836 patients who received mechanical ventilation were selected to comprise the derivation cohort.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Measurements and main results</h3><div>Backwards stepwise regression produced a model with age, BMI, sepsis, SOFA, malignancy, COPD, sex, and doses of opioids, propofol, and benzodiazepines as predictors of sedative-associated delirium. The model had very good discriminative power, with an area under the receiver-operator curve (AUROC) of 0.83. Internal validation via bootstrapping showed preserved discriminatory function with an AUROC of 0.81 and graphical evidence of good calibration. External validation in a separate set of 340 patients showed good discrimination, with AUROC of 0.70.</div></div><div><h3>Conclusions</h3><div>Risk for sedative-associated delirium during acute respiratory failure requiring mechanical ventilation can be quantified using a simple, transparent model, which can now be validated in a prospective study.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155407"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Properties of testosterone transdermal gel in restoring serum testosterone levels in critically ill patients: the TestICU-1 pilot study","authors":"Claire Dupuis ,&nbsp;Konstantinos Bachoumas ,&nbsp;Charlotte Oris ,&nbsp;Sasha Eisenberg ,&nbsp;Bruno Pereira ,&nbsp;Yves Boirie ,&nbsp;Nicolas Farigon ,&nbsp;Vincent Sapin ,&nbsp;Lise Bernard ,&nbsp;Ruddy Richard ,&nbsp;Frédéric Costes ,&nbsp;Mireille Adda ,&nbsp;Bertrand Souweine","doi":"10.1016/j.jcrc.2025.155339","DOIUrl":"10.1016/j.jcrc.2025.155339","url":null,"abstract":"<div><h3>Background</h3><div>Critical illness is associated with hypercatabolism, systemic inflammatory dysregulation and low serum concentration of testosterone (T) leading to intensive care unit (ICU) acquired weakness and altered outcome. T supplementation benefit has been reported in several illnesses but data in non-burned ICU patients are scarce. In this context, the purpose of the TestICUs-1 study was to assess the pharmacokinetic and safety of T-gel administration in ICU patients.</div></div><div><h3>Methods</h3><div>TestICUs-1 was an open, monocentric, randomized controlled study carried out in ICU patients receiving vasopressors, and mechanical ventilation for at least two days. Exclusion criteria included prostate or breast cancer, PSA levels &gt;4 ng/mL and age ≥ 80 years. The T group received a 14-day administration of T transdermal gel (Androgel©). The primary endpoint was the percentage of patients with serum Total T value within normal ranges on days 4, 7, 10 and 14. The safety of T-gel was also assessed.</div></div><div><h3>Results</h3><div>30 patients were included, 19 (63 %) were men. At inclusion, none of the men and half of the women presented a serum Total T values within normal range. On days 4, 7, 10 and 14, the percentage of patients with a normal serum Total T value did not differ between T administered patients and controls. No significant differences between groups were reported in terms of cardiovascular events and cytolysis.</div></div><div><h3>Conclusions</h3><div>The administration of T-gel did not increase significantly the percentage of patients with normal serum T values as compared to control.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155339"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose corticosteroids in cirrhotic patients with septic shock or vasopressor-dependent shock: A systematic review and meta-analysis","authors":"Leonardo Corrêa Süffert ,&nbsp;Enzo Arthur Bruno Pergher ,&nbsp;Henrique Steffens de Abreu ,&nbsp;Isabella Heringer Padilha ,&nbsp;Luis Pedro Possapp Beis ,&nbsp;Diego Rodrigues Falci ,&nbsp;Bruna Cerbino ,&nbsp;Marcelo Campos Appel da Silva ,&nbsp;Guilherme Grossi Lopes Cançado","doi":"10.1016/j.jcrc.2025.155405","DOIUrl":"10.1016/j.jcrc.2025.155405","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze whether the use of low-dose corticosteroids in cirrhotic patients with septic shock or other forms of vasopressor-dependent distributive shock translates into significant clinical benefits and reduced in-hospital mortality.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane CENTRAL were searched for randomized controlled trials (RCTs) and observational studies comparing the use of corticosteroids versus control in cirrhotic patients with septic shock or other distributive vasopressor-dependent shock. Outcomes were analyzed using risk ratios (RR) with 95 % confidence intervals (CIs) and mean differences (MD). Heterogeneity was assessed using the I² statistic.</div></div><div><h3>Results</h3><div>Six studies (2 RCTs, 4 observational cohorts), totaling 514 patients, were included. Corticosteroids had no effect on in-hospital mortality (RR: 0.99; 95 % CI: 0.86–1.13; <em>p</em> = 0.832; I² = 46.2 %), but reduced refractory shock related mortality (RR: 0.16; 95 % CI: 0.06–0.41; <em>p</em> &lt; 0.001; I² = 0 %) and increased shock resolution (RR: 1.42; 95 % CI: 1.13–1.78; <em>p</em> = 0.003; I² = 52.3 %). No benefit was observed in vasopressor-free days (MD: 2.06; 95 % CI: -0.86 to 4.99; <em>p</em> = 0.166; I² = 58.6 %). Adverse events were higher for gastrointestinal bleeding (RR: 2.73; 95 % CI: 1.15–6.52; <em>p</em> = 0.023; I² = 0 %) and new organ failure (RR: 1.42; 95 % CI: 1.01–1.99; <em>p</em> = 0.045; I² = 0 %).</div></div><div><h3>Conclusion</h3><div>Low-dose corticosteroids in cirrhotic patients with septic or vasopressor-dependent distributive shock show limited benefit, as improved shock resolution and reduced shock-related mortality did not translate into in-hospital survival and may increase the risk of severe adverse events.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155405"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “Recovery of motor functions and cognitive functions in patients with intensive care unit–acquired weakness”","authors":"Jinyin Bai ,&nbsp;Guifen Gan","doi":"10.1016/j.jcrc.2025.155351","DOIUrl":"10.1016/j.jcrc.2025.155351","url":null,"abstract":"<div><div>We congratulate Aoyama et al. for demonstrating that cognitive status at ICU discharge is linked to 4-week motor recovery in ICU-AW survivors (J Crit Care 2026; 91:155273). We caution, however, against causal over-interpretation of this retrospective cohort, urge adoption of target-trial emulation (inverse-probability weighting or instrumental variables) and a prospective, adequately powered (≈ 120 patients) multicentre RCT. Routine post-ICU cognitive screening (MoCA) and delirium monitoring (CAM-ICU) could enable early triage to multidisciplinary rehabilitation and should be validated in nationwide data.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155351"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of superior vena cava variability by transthoracic echocardiography as a fluid responsiveness predictor in critically ill patients","authors":"Diego Ugalde ,&nbsp;Jorge Montoya ,&nbsp;Juan N. Medel ,&nbsp;Daniela Eisen ,&nbsp;Antoine Vieillard-Baron","doi":"10.1016/j.jcrc.2025.155420","DOIUrl":"10.1016/j.jcrc.2025.155420","url":null,"abstract":"<div><h3>Background</h3><div>Fluid administration is frequent in critically ill patients and its used should be tailored. A recent window to evaluate the superior vena cava variability (SVC) obtained with transthoracic echocardiography might allow fluid responsiveness prediction. Our objective is to evaluate its diagnostic accuracy as such.</div></div><div><h3>Methods</h3><div>We conducted a prospective study in a single intensive care unit in an academic center, including consecutive sedated, ventilated adults with elevated lactate or abnormal clinical perfusion or norepinephrine infusion of 0,1 μg/kg/min or more with &lt;7 days of stay, excluding patients with inadequate acoustic window or special contact precautions. We performed a transthoracic critical care echocardiography adding the SVC respiratory variability and then a mini-fluid challenge as a reference test to evaluate its diagnostic accuracy and obtaining the area under receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>From 100 patients, 55 were excluded, mainly because of insufficient acoustic window. In 45 analysed patients, 16 were fluid responders and 29 non-responders. SVC had an AUROC of 0,88. A cutoff value of 10,14 % had 93.75 % sensitivity and 75.86 % specificity with Youden's index of 0,69,912 while 19,42 % was a high specificity cutoff and 16,03 % a balanced one.</div></div><div><h3>Conclusion</h3><div>Transthoracic SVC variation is hard to obtain and has a good diagnostic accuracy for detecting fluid responsiveness and it could be used in some ventilated patients with hemodynamic instability.</div><div>Registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: <span><span>NCT05211765</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155420"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning survival analysis for predicting kidney disease progression in patients with acute kidney injury undergoing continuous kidney replacement therapy: An analysis of the LINKA database","authors":"Donghwan Yun ,&nbsp;Ari Hong ,&nbsp;Kwangsoo Kim ,&nbsp;Jeonghwan Lee ,&nbsp;Yaerim Kim ,&nbsp;Kyubok Jin ,&nbsp;Ji Eun Kim ,&nbsp;Shin Young Ahn ,&nbsp;Gang-Jee Ko ,&nbsp;Seokwoo Park ,&nbsp;Sejoong Kim ,&nbsp;Hee-Yeon Jung ,&nbsp;Jang-Hee Cho ,&nbsp;Sun-Hee Park ,&nbsp;Eun Sil Koh ,&nbsp;Sungjin Chung ,&nbsp;Jung Pyo Lee ,&nbsp;Jung Nam An ,&nbsp;Sung Gyun Kim ,&nbsp;Dong Ki Kim ,&nbsp;Seung Seok Han","doi":"10.1016/j.jcrc.2025.155419","DOIUrl":"10.1016/j.jcrc.2025.155419","url":null,"abstract":"<div><h3>Purpose</h3><div>The progression of acute kidney injury (AKI) to end-stage kidney disease (ESKD) poses challenges due to high risks of comorbidities and poor outcomes. This study aimed to develop and validate machine learning survival models for predicting ESKD in patients receiving continuous kidney replacement therapy (CKRT) for AKI.</div></div><div><h3>Methods</h3><div>A total of 1444 AKI patients who survived beyond one week after CKRT were included. Data from six hospitals were used to develop the model, and data from two hospitals formed the validation cohort. A comprehensive set of 122 clinical and laboratory variables was utilized to construct prediction models, including CoxBoost, Elastic-Net Cox, random survival forest, and Cox proportional hazards models. Model performance was assessed using the concordance index (C-index).</div></div><div><h3>Results</h3><div>The CoxBoost model demonstrated superior performance, with a C-index of 0.811 (95 % confidence interval, 0.756–0.865) in the internal validation cohort and 0.742 (0.700–0.788) in the external validation cohort. This model reduced the variable set to 23 key parameters, with 24-h urine output on day 7 of CKRT, preexisting chronic kidney disease, and day 7 kidney function and systemic laboratory measures identified as the most critical predictors. A simplified scoring system derived from six binarized variables effectively stratified patients into low-, intermediate-, and high-risk groups for ESKD progression.</div></div><div><h3>Conclusion</h3><div>This machine learning survival approach highlights a set of critical, readily measurable predictors of ESKD risk and may support targeted risk stratification, bedside decision-making, and more efficient allocation of post-CKRT surveillance and kidney-care resources.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"92 ","pages":"Article 155419"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}